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Effectiveness of Interventions for Central Serous Chorioretinopathy: A Meta-analysis

This network meta-analysis compares the effectiveness of various interventions for central serous chorioretinopathy (CSC), such as anti-VEGF drugs, PDT, laser treatment, beta-blockers, and nutritional supplements. The study found that no single treatment has overwhelming evidence of efficacy, and it remains unclear if treating acute CSC provides clinically important benefits.

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Effectiveness of Interventions for Central Serous Chorioretinopathy: A Meta-analysis

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  1. Interventions for central serous chorioretinopathy: a network meta-analysisMahsa Salehi, Adam S Wenick, H Andrew Law, Jennifer R Evans, Peter GehlbachIssue 1, 2016 A presentation to: Meeting name Date

  2. Table of Contents

  3. 01: Background • Central serous chorioretinopathy (CSC) is characterized by serous detachment of the neural retina • CSC can be treated with many different interventions • It is not known which treatments offer advantages over others • Objective: • To compare the relative effectiveness of interventions for central serous chorioretinopathy

  4. 02: Types of studies Participants 25 studies; 1098 eyes of 1098 participants Interventions Anti-VEGFs, PDT, laser treatment, beta-blockers, carbonic anhydrase inhibitors, Helicobactor pylori treatment, and nutritional supplements

  5. 03: Key results • “…little difference in the effect of anti-VEGF (ranibizumab or bevacizumab) or observation on change in visual acuity at six months.” • Mean difference 0.01 LogMAR, 95% CI -0.02 to 0.03, 64 participants • “…half-dose PDT treatment of acute CSC probably results in a small improvement in vision, less recurrence, and less persistent CSC at 12 months compared to sham treatment.”

  6. 03: Key results (continued) • “…two trials comparing anti-VEGF to low-fluence PDT in chronic CSC found little evidence for any difference in visual acuity at 12 months.” • “More people in the anti-VEGF group had persistent CSC at 12 months” • RR 6.19, 95% CI 1.61 to 23.81, 34 participants • “…laser treatments may lead to better visual acuity.” • MD -0.20 logMAR, 95% CI -0.30 to -0.11, 45 participants

  7. 04: Tables

  8. 05: Conclusions • “… no single treatment has provided overwhelming evidence of efficacy in published RCTs.” • “It is not clear whether there is a clinically important benefit to treating acute CSC which often resolves spontaneously…”

  9. 06: Acknowledgements • Cochrane Eyes and Vision US Satellite, funded by the National Eye Institute, National Institutes of Health • Cochrane Eyes and Vision Editorial Base, funded by the UK National Health Service Research and Development Programme • Mahsa Salehi, Adam S Wenick, H Andrew Law, Jennifer R Evans, Peter Gehlbach • Review citation • Salehi M, Wenick AS, Law HA, Evans JR, Gehlbach P. Interventions for central serous chorioretinopathy: a network meta-analysis. Cochrane Database of Systematic Reviews 2015, Issue 12. Art. No.: CD011841. DOI: 10.1002/14651858.CD011841.pub2.

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